United States District Court, N.D. Illinois
BERNARD J. NOBLE, Plaintiff
CAROLYN W. COLVIN,  Commissioner of Social Security, Defendant
For Bernard J Noble, Plaintiff: Frederick J. Daley, Jr., Daley, DeBofsky & Bryant, Chicago, IL.
For Michael Astrue, Defendant: Harpreet Kaur Chahal, LEAD ATTORNEY, AUSA-SSA, United States Attorney's Office (NDIL), Chicago, IL.
MEMORANDUM OPINION AND ORDER
Honorable Michael T. Mason.
Claimant Bernard Noble (" Noble" or " Claimant" ) has filed a motion for summary judgment seeking judicial review of the final decision of the Commissioner of Social Security (" Commissioner" ). Noble seeks Disability Insurance Benefits (" DIB" ) and Supplemental Security Income (" SSI" ) under the Social Security Act, 42 U.S.C. § § 216(i), 223, 1611, and 1614 (the " Act" ). The Commissioner has denied his request. The parties have consented to the jurisdiction of this Court pursuant to 28 U.S.C. § 636(c). For the reasons set forth below, Noble's motion for summary judgment is granted and this case is remanded for further proceedings consistent with this opinion.
A. Procedural History
Noble filed an application for DIB and SSI on January 3, 2008, alleging a disability onset date of June 26, 2007. (R. 21.) His claim was denied initially on March 13, 2008. (R. 95-103.) Noble made a timely request for reconsideration, which was denied on June 27, 2008. ( Id. ) Thereafter, Noble requested a hearing, which was held on August 25, 2009 before ALJ Jose Anglada
(the " ALJ" ). (R. 39-94.) On October 27, 2009, the ALJ issued a written decision denying Noble's request for benefits. (R. 18-36.) Noble filed a timely request for review, which the Appeals Council denied on March 16, 2011. (R. 8-11.) The ALJ's decision then became the final decision of the Commissioner. Estok v. Apfel, 152 F.3d 636, 637 (7th Cir. 1998); 20 C.F.R. § 416.1481. Noble subsequently filed this action in the District Court.
B. Medical Evidence
Noble seeks DIB and SSI for disabling conditions stemming from chronic heart failure, cardiomyopathy, obesity, hypertension, obstructive sleep apnea, and degenerative disorder of the back.
1. Advocate South Suburban Hospital
On June 28, 2007, Dr. Ricardo Vicuna examined Noble after he complained of chest pain. (R. 377.) Dr. Vicuna noted that Noble came to the emergency room because he was experiencing persistent chest pain on his left side, which radiated down his left shoulder. ( Id. ) Dr. Vicuna also noted that an initial electrocardiogram and three sets of cardiac enzymes were normal. ( Id. ) Noble underwent a chest radiograph and another electrocardiograph. (R. 346, 376.) The chest radiograph found left posterior basilar discoid atelectasis, and the electrocardiograph showed a T-wave abnormality indicative of anterolateral ischemia. ( Id. ) Dr. Vicuna recommended cardiac catheterization. (R. 377.) This recommendation was based on the radiograph results, as well as Noble's family history of coronary artery disease with angina, his chest pain, his dynamic electrocardiographic changes, and his moderate atrial enlargement left ventricular systolic function. ( Id. ) Dr. Vicuna also reported that Noble had a left ventricular ejection fraction of 29%. ( Id. )
That same day, Dr. Abdul Ghani, a cardiologist at Advocate South Suburban Hospital, performed a left heart catheterization with selective coronary angiography, left ventriculography, right femoral angiography, and the successful deployment of AngioSeal. (R. 378.) At this time, Dr. Ghani noted that Noble complained of intermittent chest pain and dyspnea from walking one block. (R. 311.) Dr. Ghani reported that there was no significant disease in the left artery and stated that Noble tolerated the procedure well. (R. 378.) He also found that the left ventriculography " reveals ejection fraction of 15-20%." ( Id. ) Dr. Ghani's impression was that Noble had severe nonischemic dilated cardiomyopathy. (R. 379.) On June 29, 2007, Dr. Ghani performed another angiogram, which showed a left ventricular ejection fraction of 20%. (R. 282, 311.) After that time, Noble continued to complain of intermittent periods of chest pain and dyspnea when walking a block. (R. 311.)
2. Advocate Christ Medical Center
In August of 2007, Noble began seeing Dr. Marc Silver, Director of the Heart Failure Institute at Advocate Christ Medical Center. (R. 311, 313-14.) Noble reported to Dr. Silver that he had continuing shortness of breath when walking a block, he was snoring, and he was not sleeping well due to the chest pressure. (R. 296.) He also reported to Dr. Silver that his primary physician, Dr. Charlotte Mitchell, had instructed Noble to limit his activity. ( Id. )
One month later, on September 26, 2007, Noble reported feeling " tremor-like," " flutter-like" and " thumping" feelings in his chest and he had several episodes of lightheadedness. (R. 292.) On October 25, 2007, Noble saw Dr. Silver again and reported chest pressure and shortness of breath, and stated that he naps daily and gets no regular exercise. (R. 290.) Dr. Silver noted that Noble had a right arrhythmia
and he recommended a holter monitor test and sleep study. ( Id. )
On October 29, 2007, Noble went to the Advocate Christ Medical Center for a holter monitor study. (R. 281.) The holter monitor report noted that Noble had a history of congenitive heart failure and an irregular heart beat. ( Id. ) The report stated: " [t]he rhythm remained normal throughout with average heart rate of 85 beats per minute. Isolated PVCs were noted (total of 235) without any evidence of ventricular couplets, ventricular bigeminy or ventricular tachycardia. There is no evidence of a supraventricular tachyarrhythmia, AV blocks or long pauses either." ( Id. )
On November 5, 2007, Noble saw Dr. Silver after he again went to the emergency room. (R. 311-12.) Noble had been experiencing more palpitations and slight chest pressure. (R. 311.) At this time, he was not experiencing dyspnea. ( Id. ) He underwent an electrocardiogram, which indicated repolarization abnormalities. ( Id. ) Dr. Silver believed that Noble suffered from dilated cardiomyopathy. ( Id. ) He noted that Noble had normal epicardial coronary arteries. ( Id. ) He also reported that there was no evidence of active myocardial ischemia. (R. 312.) Dr. Silver increased Noble's Carvelidol prescription and sent him home. ( Id. )
After this emergency room visit, Dr. Silver sent a letter to Dr. Mitchell expressing concern about the early onset of Noble's dilated cardiomyopathy. (R. 313.) Dr. Silver also expressed that he remained confident about the treatment and he reserved the decision on implanting a defibrillator until after Noble underwent his CPAP (continuous positive airway pressure) titration study and his heart failure therapy. (R. 313-14.) Dr. Silver also noted that Noble had recently lost some weight and that he was hypertensive. ( Id. ) Dr. Silver believed Carvedilol titration would help Noble's blood pressure and his heart failure. ( Id. ) He also noted that there was no reason Noble could not return to work and that Noble and his wife were planning to take a cruise vacation in the near future. ( Id. )
On November 7, 2007, Noble saw Dr. Peter Razma at Advocate Christ Medical Center for a sleep study. (R. 300-01.) Dr. Razma concluded that Noble had " [m]oderately severe obstructive sleep apnea, worse in supine position and during REM." ( Id. ) Dr. Razma believed that Noble " should undergo a CPAP titration study for treatment of this," followed by " [c]areful clinical follow-up" as to how effective the CPAP was for treating Noble's sleep apnea. ( Id. ) Dr. Razma further stated, " [c]ertainly his obstructive sleep apnea may be contributing to the development or fostering some worsening of his congestive heart failure." (R. 309.) On November 22, 2007, Dr. Razma noted that Noble had continued dyspnea, poor sleep, and " excessive daytime hypersomnolence." (R. 302.) He recommended a CPAP titration study " immediately." ( Id. )
Noble saw Dr. Silver again on November 26, 2007, and reported that he was experiencing shortness of breath when walking a short distance, as well as fatigue, and that he was napping daily. (R. 287.) He also complained of chest pressure and occasional jaw pain. ( Id. ) Dr. Silver noted that Noble was still experiencing pounding or fluttering in his chest once per week, especially at night. ( Id. ) Dr. Silver noted that Noble had been fitted for a mask to help with his sleep apnea, and he recommended that Noble try to exercise and increase his medication. (R. 288.)
On December 3, 2007, Noble was on vacation when he contacted Dr. Silver, reporting the feeling of a pounding heart and coughing spells. (R. 286.) The following day, after taking some prescribed Lasix,
Noble was feeling much better and was able to move around more. (R. 285.)
On May 21, 2008, Noble again reported suffering from palpitations, chest pressure and dyspnea after walking a few steps. (R. 411, 413.) Dr. Silver noted that Noble was not wearing his CPAP mask as directed and he occasionally missed his medication. ( Id. ) He also noted that Noble had taken Lasix the previous night and had a good response. ( Id. ) On May 30, 2008, Noble underwent an echocardiogram at Dr. Silver's request. (R. 390.) That report indicated cardiomyopathy, an enlarged ventricle, and mild hypertrophy. ( Id. ) It also indicated the left ventricular systolic function was mild to moderately impaired, the inferior wall was severely hypokinetic compared to the anteroseptal area, and the lateral wall and apex were also hypokinetic with an estimated ejection fraction of 40-45%. ( ...